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Estimates were weighted by age, race/ethnicity, and sex distribution of each states population, and 95% confidence intervals were calculated by using SUDAAN

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Over time, smoking can cause: Chronic inflammation that makes the vocal folds swollen and stiff Thickening of tissue , which changes how your voice sounds Reduced flexibility , making it harder to control pitch and volume Increased mucus , leading to frequent throat clearing This is why many smokers develop a voice that sounds deeper, rougher, or constantly hoarse

July 31, 2018